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Smart drugs and me

I have a confession to make. I have taken a smartdrug. It was not prescribed for me, norwas it bought from a registered pharmacy. It improved my alertness, increased my attention and allowed me to workfor longer. But you can hang up yourcall to the GPhC. I’m talking aboutcaffeine.

It might seem I’m beingfrivolous, but I think it’s an important comparison to make. If you’ve read the recent PJspecial, you’ll recognise caffeine as a nootropic. It feels an odd label to apply to caffeine as it’s socially acceptable. That makes it comicalto throw at it what is thrown at other nootropics. No one is concerned about the lack of a universitycaffeine policy, pre-exam caffeine tests haven’t been recommended and there isno suggestion of public concern about pharmacists under the influence of caffeine.

Is it just social prejudice, and statusquo bias, which makes nootropics seem scary? Or is there a real fundamental difference between caffeine and othernootropics?

Safety is an obviousdifferentiator and a concern raised. There is no question that other nootropics are more dangerous thancaffeine. But as pharmacists we acceptpatient autonomy and encourage patients to make their own risk/reward decisions.

Other concerns are expressed which Idon’t share. One is that nootropicsprovide an unfair advantage. But I don’tsee how it differs to the advantage provided by an expensive private educationor similar. Another is that they unduly exaggerateperformance. But performance of thosetaking nootropics is not so divorced from reality that those not ‘under theinfluence’ present a safety risk. And Ifind odd any suggestion of public concern. Why would patients not want those treatingthem to be taking something that improves their competence? I imagine patients would be more concerned atthe prospect of being treated by someone deprived of caffeine at 4am.

Ultimately, nootropics improveperformance. In healthcare, thattranslates to improved patient care. More research is clearly needed, but I don’t think a starting point ofcontempt, as has beenexpressed, is the right one.

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